Helping the Little People

Since early childhood, Erick Carstensen, 14, has suffered because of his stature: he is a victim of hereditary dwarfism. Brick's contemporaries, who generally towered over him, excluded him from their games. Teachers were often equally unsympathetic, calling him "Shorty" and browbeating him for his inability to keep up with his classmates in physical education. Even the doctors consulted by his parents provided little in the way of relief. According to Erick's mother, Mrs. Dorothy Carstensen of Los Angeles: "They'd all say the same thing: 'Don't worry about it. He'll shoot up overnight.' "

Erick has indeed been growing at a faster rate than most of the other 50,000 dwarfs in the U.S. have experienced. But that is only because he has had expert medical help; six months ago, his mother enrolled him in the dwarf clinic operated by the University of California at Los Angeles, the only facility in the world devoted exclusively to the treatment and study of dwarfism. There, twice a week, he receives an injection of a pituitary hormone, the primary substance that triggers human growth. He has grown 2 1/2 in. (to 4 ft. 10 in.) since treatment was started, and the clinic doctors are confident that he will now reach a height of at least five feet.

Short Supply. The dwarf clinic, now marking its second anniversary, is the creation of Dr. David Rimoin, a U.C.L.A. geneticist and one of the world's leading authorities on dwarfism. Rimoin believes that the condition (which occurs once in every 10,000 births in the U.S.) is almost universally misunderstood, largely because so few doctors have taken the trouble to learn about it. Says he: "To most doctors, all dwarfs look alike."

Most doctors might see only one dwarf professionally during their careers; Rimoin's clinic, located at Los Angeles' Harbor General Hospital and staffed by ten physicians, sees 500 a year. Rimoin and his colleagues can now identify at least 50 types of dwarfism, and have determined the causes of many of these abnormalities. Midgets, who are tiny but normally proportioned, are usually victims of an underactive pituitary gland, a pea-sized organ at the base of the brain that is largely responsible for the secretion of growth hormone (HGH). Other dwarfs, who tend to have normal-sized heads and trunks but extremely short arms and legs, usually have different hormone deficiencies.

Like Erick, most midgets, or pituitary dwarfs, can be helped to achieve near-normal growth through injections of HGH. But while efforts are under way to synthesize the substance in large amounts, HGH can now be obtained only from the pituitaries of human cadavers, which are in short supply. Rimoin estimates that 25% of the midget population could be helped by hormone therapy; at present, only 10% are able to obtain treatment.

Heaven Sent. The Los Angeles clinic also deals with many of the other problems connected with dwarfism. Some dwarfs have severe spinal defects that can lead to paralysis if not promptly treated. Others suffer from deteriorating vision and a wide variety of orthopedic problems that most doctors cannot correctly diagnose or treat. Mrs. Estrella Sberna of Los Angeles took her daughter Mary Lou, 12, to dozens of different doctors for problems ranging from a cleft palate to flat feet. But it was only at the clinic that Mary Lou began to receive proper treatment after doctors diagnosed her condition as Kniest syndrome, a type of dwarfism in which the cartilage is dotted with holes.

Actor Michael Dunn, 38, who is best known for his performance in the film Ship of Fools, consulted several specialists in search of a cure for the arthritis he feared might force him to give up show business. He finally found help at the clinic, where surgeons operated to tighten his knee ligaments and reduce the pain in his legs. That surgery, says Dunn, saved his career.

Others credit the clinic with preserving their sanity. Los Angeles House wife Shirley Figone, who is normal sized, was upset about her dwarf son Chris, 2, until Rimoin arranged for her to meet a dwarf couple with the opposite problem -- their normal-sized daughter was embarrassed by them. The meeting helped breach the isolation that so often surrounds dwarfs and their families. "We're saving a scrapbook for Chris, cutting out any newspaper stories we can find concerning little people," says Mrs. Figone. "We want him to know that he's not alone."

Rimoin believes that most dwarfs can be helped, physically and mentally. Indeed, he says, even Tom Thumb, the midget exhibited and exploited by Circus Impresario P.T. Barnum, could have achieved near-normal growth had treatment been available 100 years ago. But with that treatment, Rimoin admits, Tom would probably never have become rich and famous.

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